Potential patient harms from misinterpretation of publically reported surgical outcomes

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

To determine how the general public interprets surgical complication rates presented from a publicly available online surgical-rating website.

Subjects and Methods

An in-person electronic survey was administered at the local State Fair to a convenience sample. Participants were presented with a representative output from an online surgeon-rating website and were asked to choose from three statistically equivalent surgeons for a hypothetical medical decision. We then suggested that their insurance company would only cover one surgeon and probed their willingness to pay to switch surgeons for a small chance of lowering the risk of a complication (0.7%, 95% confidence interval [CI] −8.1% to 9.5%, P = 0.9). We quantified the characteristics of those willing to switch, the degree of misinterpretation, and the subsequent potential patient harms.

Results

There were 343 completed responses. When presented with a hypothetical healthcare decision, most participants (n = 209, 61%) said they were willing to pay out-of-pocket expenses to switch to a statistically equivalent surgeon. Those who were willing to pay to switch surgeons were more likely to be older (odds ratio [OR] 1.02, 95% CI 1.01–1.03), poorer (OR 1.81, 95% CI 1.07–3.11), previously had cancer (OR 5.9, 95% CI 1.9–25), and misinterpreted the data (OR 3.03, 95% CI 1.87–4.96). Those who were willing to pay out-of-pocket expenses were more inaccurate in their estimation of surgeon complication rates (mean estimate 34.0% vs 8.9%, P < 0.001, correct rate = 3.6%), and on average were willing to pay $6 494 (95% CI 4 108–8 880).

Conclusion

Understanding of a publicly reported surgical-complication website is often prone to misinterpretation by the general population and may lead to patient harm from a financial aspect.

Related Topics

    loading  Loading Related Articles